The Cost of Paid Family Leave Law

The Washington D.C. Council recently introduced legislation to provide workers with up to 16 weeks of paid family leave. Hailed by some, it may serve as a model for national paid leave. But if the D.C. proposal were implemented nationwide, the costs and deficits would be immense. AAF analysis found it would cost between $306.6 billion and $1.9 trillion per year to provide 16 weeks of paid family leave nationwide. For each worker who takes 16 weeks paid leave, it would cost the government on average $12,900. Perversely, the higher income the worker, the larger the benefit received; 56.7 percent of benefits from the policy would go to workers who individually earn over $1,000 per week or $52,000 per year.

The Broad Implications of the Newly Invalid US-EU Data Pact

Exposure to lawsuits from data breaches and other failures to protect privacy are part and parcel of digital commerce. For global companies, the exposure of lawsuits in multiple jurisdictions with differing standards is a potential impediment to the free-flow of data and effective global competition. Unfortunately, the European Court of Justice (ECJ), the highest European court, has thrown a wrench in the system by invalidating the “Safe Harbor Provision,” which granted free flow of information between the U.S. and the Europe.

Hospitals with Higher Net Income More Likely to Receive Bonus Payment

Hospitals with Higher Net Income More Likely to Receive Bonus Payment

After three years of providing penalties and bonuses to hospitals treating Medicare patients through the Affordable Care Act’s (ACA) Hospital Value-Based Purchasing (HVBP) Program, the Government Accountability Office (GAO) has found that the amount of a hospital’s payment adjustment is well-aligned with the hospital’s net income—hospitals with a higher net income received the largest bonuses. This finding is not all that surprising (with one exception: hospitals in the lowest net income range in 2013 had the second-highest payment adjustment in 2015). While potentially a chicken-and-egg situation, hospitals with low or negative net income are not likely to have the available resources necessary to make needed improvements. When a hospital is penalized for its poor performance, the situation worsens. In all three years, average payment adjustments for safety net hospitals were negative. Interestingly, the most commonly cited challenge to improving quality was health information technology (IT), which every hospital is being required to utilize in the hopes that such technology will catalyze quality improvements. Additionally, the GAO found “no apparent shift... in hospitals’ performance on the quality measures included in the HVBP program”.

Primer: Veterans Health Care

Many veterans of the United States military receive health care through the Veterans Health Administration (VHA), a division of the Department of Veterans Affairs (VA). The VHA provided care to more than 8.7 million veterans (40 percent of all living veterans) in 2014. It operates more than 1,700 VA facilities with nearly 304,000 employees, making it the country’s largest integrated health care system. VA health care is not an insurance plan but rather allows veterans to receive health care treatments and services, either at no cost to them or for a copayment (depending upon eligibility), so long as such services are received at a VA clinic or hospital. Most veterans who served at least two years in active duty and received a non-dishonorable discharge are eligible to receive health care through the VA. Veterans with 20 or more years of service who have retired from the military are eligible to receive TRICARE benefits, administered by the Department of Defense (DOD) rather than the VA—although some retirees use both systems.

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